Provider Demographics
NPI:1154321818
Name:REDMAN, KAY LYNNE (MD)
Entity Type:Individual
Prefix:DR
First Name:KAY
Middle Name:LYNNE
Last Name:REDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 2ND ST # 3
Mailing Address - Street 2:
Mailing Address - City:LIMON
Mailing Address - State:CO
Mailing Address - Zip Code:80828-5133
Mailing Address - Country:US
Mailing Address - Phone:319-651-9936
Mailing Address - Fax:
Practice Address - Street 1:615 2ND ST # 3
Practice Address - Street 2:
Practice Address - City:LIMON
Practice Address - State:CO
Practice Address - Zip Code:80828-5133
Practice Address - Country:US
Practice Address - Phone:319-651-9936
Practice Address - Fax:505-782-7551
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO48810207R00000X
NC200100082207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000K6482Medicaid
NM000K6482Medicaid
H45411Medicare UPIN